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Updated: Jun 8, 2026
A Novel Approach to Assess Motor Outcome of Deep Brain Stimulation Effects in the Hemiparkinsonian Rat: Staircase and Cylinder Test
Published on: May 31, 2016
Clinical motor outcome of bilateral subthalamic nucleus deep-brain stimulation for Parkinson's disease using
Helen Brontë-Stewart1, Stephanie Louie, Sara Batya
1Departments of Neurology and Neurological Sciences and of Neurosurgery, Stanford University, Stanford, California 94305-5327, USA. hbs@stanford.edu
Background:
Image-guided neuronavigation has largely replaced stereotactic frames when precise, real-time anatomic localization is required during neurosurgical procedures. However, some procedures, including placement of deep-brain stimulation (DBS) leads for the treatment of movement disorders, are still performed using frame-based stereotaxy. Despite the demonstration of comparable accuracy between frame-based and "frameless" image-guided approaches, the clinical efficacy of frameless DBS placement has never been reported.
Objective:
To analyze the outcomes of subthalamic nucleus (STN) DBS using the frameless technique for the treatment of Parkinson's disease (PD).
Methods:
Of 31 subjects (20 men) with PD for 10 ± 4 years, 28 had bilateral STN DBS and 3 had unilateral STN DBS. The Unified Parkinson's Disease Rating Scale (UPDRS) motor scale (III) and total medication doses were assessed before surgery on and off medication and off medication/ON DBS (off/ON) after 6 to 12 months of STN DBS.
Results:
There was a 58% improvement from bilateral STN DBS in the UPDRS III (40 ± 16 preoperatively off, 17 ± 11 off/ON) 9.6 ± 1.9 months after surgery (P < .001). This compared favorably with the published outcomes using the frame-based technique. All motor subscores improved significantly (P < .01). The mean reduction in medication was 50%. No intraoperative complications occurred, but one subject with hypertension died of a delayed hemorrhage postoperatively. Two subjects developed postoperative infections that required lead removal and antibiotics.
Conclusions:
Bilateral STN DBS for PD performed by an experienced team using a frameless approach results in outcomes comparable to those reported with the use of the frame-based technique.
